Acid-Alkali Imbalance - Can Be a Factor in Fatigue, Muscle Pain, and More

Dr. Sarah Myhill, MD, is a UK-based fatigue specialist focused on nutrition and preventive medicine. This information is reproduced with kind permission from her educational website (DrMyhill.co.uk).*

Maintaining the correct acidity/alkalinity (or pH) of the blood is an essential part of good health.

Acidity and alkalinity is determined by the concentration of hydrogen ions - the lower the pH, the greater the acidity and the greater the concentration of hydrogen ions.

It is important to realize the pH scale is a logarithmic one. This means that the difference between a pH of 7 (healthy neutral) and 4 (very acid) means a thousand-fold increase in hydrogen ions. Such a shift would have a massive effect on biochemical processes, most of which are exquisitely sensitive to pH changes.

For normal metabolism, the pH of the blood is tightly controlled by the lungs and the kidneys.

• In the short term the lungs compensate where there is a tendency to acidosis by slowing breathing, so retaining carbon dioxide and increasing bicarbonate, and with that pH. [Bicarbonate is the body's acid buffer.]

• In the medium term the kidneys compensate - where there is acidosis, we pee out acid.

This works fine when we have enough acid or bicarbonate to play with. We run into problems when we don't.

Where there is poor mitochondrial function, we slip into anaerobic metabolism and produce lactic acid. [For details on anaerobic vs aerobic cellular energy production, see handout on mitochondrial failure as the central cause of ME/CFS.]

This chronic overproduction puts us into a permanently acidic state. This means that any person with a tendency to fatigue and anaerobic metabolism is likely to be chronically acidotic. We try to correct this by peeing out acid, but there is only so much we can do! The possible effects of being acidic are:

• Hypoglycemia. An acidic body means we cannot release glucose from the liver, nor can we make use of sugar in blood and muscle (glycolysis is inhibited). So mitochondria are further starved of energy and the sufferer craves carbs, feeling ghastly when he does not eat.

• Muscles contract less strongly (see below).

• Acid urine strips out minerals so we lose minerals too easily. Acidic urine is a risk factor for osteoporosis.

• Plasma potassium levels may rise.

Hyperventilation will worsen any tendency to acidosis, because it washes out carbon dioxide, and therefore bicarbonate, from the blood. [See “Hyperventilation – A commonly overlooked cause of fatigue.”]

Muscles and Acidity – "Little Men Rowing a Boat"

I suspect there is another effect on muscles. To understand this, think how muscles work. There are two important protein components, namely actin and myosin. They interact like little men rowing a boat. The actin oars are dipped in the myosin water and pull, so shortening the muscle fiber. The oars are lifted out and take another bite of water, so the muscle filament is ratcheted shorter.

This process depends on the oars being alternately sticky and then letting go. This is dependent on electrical forces. One moment there is attraction and stickiness, next repulsion to let go.

These electrical forces are controlled by electrons and protons – that is, pH is vital! If the pH is wrong, the oars are too sticky, do not let go of the myosin, and there is muscle damage.

I suspect this acidic tendency clinically is associated with sore muscles, muscle cramps, spasms, tics and restless legs.

Once started on magnesium carbonate to reduce acidity, many people comment that their early morning stiff muscles are much improved!

Calcium and Acidity

One of the biochemical problems that John McLaren-Howard** has identified is a tendency for calcium to build up inside cells.

The cells try to chuck the calcium out of the way by sticking it on to calcium-containing proteins, such as calmodulin, calcium-actin or CaATPase. This is OK in the short term, but eventually these mechanisms become saturated, free ionized calcium rises and inhibits many of the mechanisms for energy production in the cell.

This calcium is not responsive to magnesium administration, so what to do about it? We honestly do not know! BUT calcium and hydrogen ions are intimately related and the optimist in me is hoping that an alkaline environment will help correct the biochemical abnormalities. Watch this space!

Diagnosis

Easy and cheap. You simply measure urine or salivary pH with litmus paper. [pH test strips are available in any drugstore]. The idea is to get the urine/saliva pH between 6.5 and 7.5 – the healthy body pH range. Water has a neutral pH of 7.0. Adjust the body's pH with judicious doses of magnesium bicarbonate starting with 1-2 grams at night, but see below! You do not want to upset normal stomach acidity at the wrong time!

Acid and Alkali in the Gut

This is a vital part of sterilizing the gut, providing the correct pH for digestion and absorption of food and minerals.

• We need a nice acid stomach (pH 4 or below) to kill off the acid-sensitive bugs. This acidity also digests protein and controls the emptying of the stomach (see "Hypochlorhydria – Lack of stomach acid, can cause lots of problems.”).

• Food remains in the stomach for 1-2 hours, then empties into the duodenum. Here we need a nice alkali environment (pH 8 – that is, a 10,000-fold decrease in hydrogen ions) to kill the alkali-sensitive bugs, and allow pancreatic enzymes to work to digest fats, carbohydrates and some proteins.

• Normally, the liver produces this bicarbonate, but can only do so if it has the raw materials to play with.

Thus by manipulating the pH in the gut we protect ourselves from infections - something which many with chronic fatigue syndrome are not good at!

• Many are helped by taking acid with meals, such as ascorbic acid (vitamin C) or betaine hydrochloride (betaine HCL, essentially stomach acid, derived from beets).

• We can help the body further by taking magnesium carbonate to neutralize this acid 1-2 hours after eating food. It is important not to take the magnesium bicarbonate with food, or the gut function will be upset.

You can check that you are somewhere near by measuring urinary pH.

Do not overdose with magnesium carbonate or you will run into problems of being too alkali. You do not have to be too accurate, as the body is very good at compensating so long as it has the basic raw materials to do so.

A traditional remedy is sodium bicarbonate. The problem is this produces a sodium [salt] load which, with Western diets, we are already overloaded with.

Magnesium carbonate is a good option because magnesium deficiency is common, and magnesium is all too easily excreted. Often people report improved bowel function as a result of the additional magnesium.

Bicarbonate and Cancer

Alkalinization has been described as ‘the poor man’s cancer treatment.’ Western diets are a major risk factor for cancer and most people eating Western diets have a tendency to acidosis.

Bicarbonate and Pain Relief

This is a traditional remedy for pain relief - most notably cystitis (urinary bladder inflammation) in women! But can be effective for other types of pain!
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* Dr. Sarah Myhill, MD, is a UK-based fatigue specialist focused on nutrition and preventive medicine. This information is excerpted with kind permission (article 458, posted October 2009) from her educational website (DrMyhill.co.uk) ® Sarah Myhill Limited, Registered in England and Wales: Reg. No. 4545198. For ME/CFS patients, a special feature of Dr. Myhill's site is her free 179-page online book - "Diagnosing and Treating Chronic Fatigue Syndrome."

** Dr. McLaren-Howard, a pioneer in nutritional and environmental medicine, co-founded the Biolab Medical Unit - a London-based lab specialized in development & provision of tests to assess bodily levels and imbalances of vitamins, minerals, and other nutrients. With Dr. Myhill, he developed the Acumen ATP Profile test of mitochondrial function.

Note: This information has not been evaluated by the FDA. It is generic and is not meant to prevent, diagnose, treat or cure any condition, illness, or disease. It is very important that you make no change in your healthcare plan or health support regimen without researching and discussing it in collaboration with your professional healthcare team.